title: Postpartum depressive symptoms and the combined load of paid and unpaid work: a longitudinal analysis.
abstract: OBJECTIVE
  To investigate the effects of total workload and other work-related factors on postpartum depression in the first 6 months after childbirth, utilizing a hybrid model of health and workforce participation.
  
  
  METHODS
  We utilized data from the Maternal Postpartum Health Study collected in 2001 from a prospective cohort of 817 employed women who delivered in three community hospitals in Minnesota. Interviewers collected data at enrollment and 5 weeks, 11 weeks, and 6 months after childbirth. The Edinburgh Postnatal Depression Scale measured postpartum depression. Independent variables included total workload (paid and unpaid work), job flexibility, supervisor and coworker support, available social support, job satisfaction, infant sleep problems, infant irritable temperament, and breastfeeding.
  
  
  RESULTS
  Total average daily workload increased from 14.4 h (6.8 h of paid work; 7.1% working at 5 weeks postpartum) to 15.0 h (7.9 h of paid work; 87% working at 6 months postpartum) over the 6 months. Fixed effects regression analyses showed worse depression scores were associated with higher total workload, lower job flexibility, lower social support, an infant with sleep problems, and breastfeeding.
  
  
  CONCLUSIONS
  Working mothers of reproductive years may find the study results valuable as they consider merging their work and parenting roles after childbirth. Future studies should examine the specific mechanisms through which total workload affects postpartum depressive symptoms.
authors.affiliation: Department of Health Services Administration, University of Maryland, College Park, MD 20742, USA. rdagher1@umd.edu
authors.forename: Rada K
authors.initials: RK
authors.lastname: Dagher
authors.forename: Patricia M
authors.initials: PM
authors.lastname: McGovern
authors.forename: Bryan E
authors.initials: BE
authors.lastname: Dowd
authors.forename: Ulf
authors.initials: U
authors.lastname: Lundberg
mesh_terms: D000203:Activities of Daily Living; D000293:Adolescent; D000328:Adult; D003710:Demography; D019052:Depression, Postpartum / Q000453:epidemiology / Q000209:etiology / Q000523:psychology*; D005260:Female; D006801:Humans; D007588:Job Satisfaction; D008137:Longitudinal Studies; D008875:Middle Aged; D008910:Minnesota / Q000453:epidemiology; D009784:Occupational Diseases / Q000453:epidemiology / Q000209:etiology / Q000523:psychology*; D011446:Prospective Studies; D016526:Workload / Q000706:statistics & numerical data; D017132:Workplace; D055815:Young Adult